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6 results

  • Impact of Periprocedural Hemoglobin Level on the Outcomes of Endovascular Thrombectomy in Acute Ischemic Stroke Patients

  • Zaid Najdawi, Mohamed Elfil, Abdallah Abbas, Lilian Maria Godeiro Coelho, Ahmed Samir, Sharon Peng, Mohammad Aladawi, Hazem S. Ghaith, Mohammad El-Ghanem, Chirag D. Gandhi, Fawaz Al-Mufti
  • Journal:
    Canadian Journal of Neurological Sciences , First View
    Published online by Cambridge University Press:
    02 April 2025, pp. 1-8
  • Background:

    Endovascular thrombectomy (EVT) is the gold standard treatment for acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). Multiple factors can influence EVT outcomes, including procedural and patient-related variables. This meta-analysis investigated the impact of periprocedural hemoglobin (Hb) levels on EVT outcomes.

    Methods:

    We performed a comprehensive literature search across PubMed, Scopus, Web of Science and Cochrane CENTRAL. We analyzed the mean difference (MD) in Hb levels between good (modified Rankin Scale [mRS] 0–2) and poor (mRS 3–6) prognosis groups. We calculated pooled odds ratios (OR) for Hb levels as a predictor of prognosis and compared mortality and symptomatic intracranial hemorrhage (sICH) across different Hb levels.

    Results:

    The analysis included 921 patients from four studies. Patients in the good prognosis group had significantly higher Hb levels (MD: 0.48 g/dL, 95% CI: [0.2, 0.75], P = 0.0007). Each 1 g/dL increase in Hb was associated with a 22% increase in the odds of achieving a good three-month prognosis (OR: 1.22, 95% CI: [1.13, 1.33], P < 0.00001). Patients with Hb levels ≤13 g/dL in males and ≤12 g/dL in females were 1.69 times more likely to experience mortality (OR: 1.69, 95% CI: [1.1, 2.59], P = 0.02). No significant difference was observed in sICH occurrence between anemic and non-anemic patients.

    Conclusion:

    Higher Hb levels may be associated with improved prognosis, and lower Hb levels might increase mortality risk in AIS-LVO patients undergoing EVT. Further research is needed to validate these findings.

  • Chapter 15 - Status Epilepticus in the Neurocritical Care Unit

  • Edited by Michel T. Torbey, Ohio State University
  • Book:
    Neurocritical Care
    Published online:
    24 July 2019
    Print publication:
    18 July 2019, pp 176-187

  • Summary

    Status epilepticus (SE) is defined as continuous or repetitive seizure activity persisting for at least five minutes without recovery to baseline between attacks [1,2]. SE may be classified into convulsive and nonconvulsive, based on the presence of rhythmic jerking of the extremities. Refractory status epilepticus (RSE) is defined as ongoing seizures failing to respond to first- and second-line anticonvulsant drug therapy. Among these patients, 10 to 15% [3] fail to respond to third-line therapy, and are considered to have super-refractory SE (SRSE) [4].